JAMES P. VANWAGNER D.O., P.C.
Medical Practice at Royal Dr, Traverse City, MI

License number
Michigan JV009579
Category
Medical Practice
Type
Orthopaedic Surgery
Owner
Name: MR. JAMES PARKER VANWAGNER D.O.
Title: OWNER
Phone: (231) 935-0957
Address
Address
5246 N Royal Dr SUITE A, Traverse City, MI 49684
National Provider ID: 1669512000
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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JAMES P. VANWAGNER, D.O., PC

Traverse City, MI

Status:
Inactive
Registration:
Jun 21, 1991
Addresses:
100 Park St, Traverse City, MI 49684 (Physical)
Michigan (Mailing)
State ID:
185087
Business type:
Domestic Professional Service Corporation
Expiration:
7-15-2011
Agent:
James A Christopherson Esq

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